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General NPI Number Information
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NPI Number | 1932204971
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Entity Type | Organization
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Legal Business Name | GREENVILLE ENDOSCOPY CENTER INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 317 SAINT FRANCIS DR SUITE 150
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City | GREENVILLE
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State | SC
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Zip | 29601-3965
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Country | US
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Telephone | 864-232-7338
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Fax | 864-232-0903
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Provider Business Mailing Address
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Address Line | PO BOX 8555
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City | GREENVILLE
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State | SC
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Zip | 29604-8555
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Country | US
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Telephone | 864-232-7338
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Fax | 864-239-6645
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOHN W HICKEY
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Credential |
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Telephone | 864-232-7338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | ASF027
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License Number State | SC
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